Outcome Domains in Child Mental Health Research Since 1996: Have They Changed and Why Does It Matter?

Abstract

Objective Child mental health treatment and services research yield more immediate public health benefit when they focus on outcomes of relevance to a broader group of stakeholders. We reviewed all experimental studies of child and adolescent treatment and service effectiveness published in the last 15 years (1996–2011) and compared the distribution and types of outcome domains to a prior review that focused on studies from the prior 15 years (1980–1995). Method Studies were included if they focused on children from birth to 18 years of age with specific or general psychiatric conditions, employed randomized designs, and examined intervention effects with a six-month or longer post-treatment assessment in treatment studies or a six-month or longer post-baseline assessment for services studies. Two hundred (n=200) studies met criteria. Reported outcome measures were coded into conceptual categories drawn from the 1980–1995 review. Results There was a five-fold increase in the total number of studies (38 versus 200) across the two 15-year time periods, with the largest increase in the number of studies that focused on consumer-oriented outcomes (from 8 to 47 studies, an almost 6-fold increase); two new domains, parent symptoms and health-related outcomes were identified. The majority of studies (95+%) continued to focus on symptoms and diagnoses as an outcome. Impact ratings were higher among studies examining four or more outcomes versus one to two outcomes in all categories with the exception of Posttraumatic Stress Disorder. Conclusions Given major shifts in healthcare policy affecting mental health services, the emergence of health and parent-related outcomes as well as greater attention to consumer perspectives parallels emerging priorities in healthcare and can enhance the relevance of child outcome studies for implementation in the real world.

IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis

“…This finding is consistent with other reviews examining outcomes measured in children's mental health research. 269 By comparison, the benefits perceived by various stakeholder groups identified in the review of qualitative studies (see Chapter 4), along with consultation with young people, parents and professionals (see Chapter 8), suggest that, although those who commission, deliver and use specialist DVA interventions undoubtedly construe symptom reduction as an important benefit, perceptions of a good outcome extended beyond this to include functional outcomes such as school attainment, the ability to cope with challenge, self-expression, self-regulation, sense of well-being (including emotional well-being, self-esteem and sense of empowerment) and improvements to relationships. These findings resonate with other studies that have sought to identify what success looks like for children accessing different types of services [270][271][272] and suggest that the narrow set of health-oriented outcomes most frequently measured in trials only partly address the benefits that are sought by those who use and commission specialist child-focused DVA interventions.…”

Intentional research design in implementation science: implications for the use of nomothetic and idiographic assessment

“…Outcomes of interest may include reductions in symptoms or disease states, improved service recipient functioning, adjustments in services received, or changes to the environmental contexts in which service recipients interact, among others [28].…”

The Peripheral Focus on the Psychological Parameters of Parents of Autistic Children in the Intervention Methods: A Review and Recommending the Strategy, Focusing Psychological Parameters of Parents of Autistic Children in Intervention Methods

“…This model of treatment evaluation thus follows but redistributes the five dimension type of treatment outcome evaluation which included symptoms and diagnosis, functioning, consumer perspectives, environments, and system (SFCES model). 39 In consideration of the SFCES framework, the proposed model assesses the symptoms and functioning of both child and parent. The overall operation of the family and the family environmental chaos, and the systemic interactions present among the child, siblings, and caregivers.…”

“…The overall operation of the family and the family environmental chaos, and the systemic interactions present among the child, siblings, and caregivers. 39 The redistribution of variables into two primary domains helps clarify the transnational nature of the relationship between childhood ASD deficits and parent and family distress. While still capturing the ''dynamic and interaction interplay between the child and his or her environments over time.…”